Ventilator-associated pneumonia: the central role of transcolonization.
Abstract
Ventilator-associated pneumonia remain frequent and serious diseases since they are associated with considerable crude mortality. Pathophysiology is centered on modifications of regional bacterial flora, especially tracheobronchial tree and oropharyngeal sphere. Bacterial migration from an anatomical area to another seems to be the main explanation of these alterations which are called "transcolonization". The association of transcolonization and lack of tightness of the endotracheal tube cuff provides a direct pathway for bacteria from the upper to the subglottic airways, eventually leading to ventilator-associated pneumonia. Although modification of bacterial flora has been largely studied, the mechanism which underlays the ability of the implantation, growing and interactions with the local microbiome that leads to the observed transcolonization remains to be more clearly deciphered. The aim of our review is to emphasize the cornerstone importance of the "transcolonization" as a nosological entity playing a central role in ventilator-associated pneumonia.
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Oral microorganisms reach the lower respiratory tract primarily through microaspiration and transcolonization in severe patients located in hospitals and sanatoriums, or elderly people with dysphagia.
“Oral microorganisms reach the lower respiratory tract primarily through these mechanisms (Soussan et al., 2019) in severe patients located in hospitals and sanatoriums, or elderly people with dysphagia.”
From Oral Microbiome and SARS-CoV-2: Beware of Lung Co-infection (2020) · cites this paper as Soussan et al., 2019
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- Authors
- Soussan, R., Schimpf, C., Pilmis, B., Degroote, T., Tran, M., Bruel, C., & Philippart, F.
- Affiliations
- Hôpital Paris Saint-Joseph (FR)
- Centre National de la Recherche Scientifique (FR)
- Corresponding author
- Philippart, François
- Venue
- Journal of Critical Care
- Publisher
- Elsevier BV
- Published
- 2019-04
- Volume
- 50
- Pages
- 155-161
- ISSN
- 0883-9441 (ISSN-L)
- OpenAlex
- W2904867943
- Cited by
- 46
- References
- 80
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 2 · 2023: 6 · 2022: 12 · 2021: 8 · 2020: 6 · 2019: 2
- FWCI
- 0.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Critical Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Keywords
- ventilator-associated pneumonia, bacterial migration, endotracheal tube cuff leak, oropharyngeal microbiota, upper airway colonization, pathogenesis
- MeSH terms
- Bronchi, Critical Care, Cross Infection, Humans, Intensive Care Units, Intubation, Intratracheal, Respiration, Artificial, Respiratory System, Trachea, Pneumonia, Ventilator-Associated, Microbiota
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